Do I Need to Crown Every Tooth?
Question submitted by Earl
I went to a dentist who advertises as a cosmetic dentist in my area hoping to improve my smile. I was hoping to get my front teeth worked on so that when I smile I am not embarrassed. This dentist is suggesting I get a dental crown on every tooth so that the smile will be uniform. The advantages are that he guarantees the work for three years. He also offers dental sedation which is good because I’m not the easiest patient to deal with in the dental chair. The only thing that worries me is the idea of grinding down healthy teeth which aren’t really going to be visible when I smile, like my bottom and back teeth. Am I over thinking this?
Earl
Dear Earl,
No, you are definitely not overthinking things. In fact, I concerned about a few of the things I am hearing. First, the standard procedure for a smile makeover uses porcelain veneers, not dental crowns. This ensures that only the minimal amount of tooth structure is removed. Crowning every tooth is known as a full-mouth reconstruction, which is only done when there are severe bite problems with the patient from things like teeth grinding or TMJ Disorder.
Unless there is something wrong with your front teeth that requires dental crowns, I am concerned about his recommendation. Usually, a dentist who recommends crowns instead of porcelain veneers does so because he or she is uncomfortable with the veneers. This is a sign that they do not have cosmetic dentistry training.
Another sign, which tends to back up my concerns is that he is saying in order to get the smile to match you would need to have all of the teeth crowned. That is a massive overtreatment. A skilled cosmetic dentist should be able to get a single tooth to match the rest of the smile. You shouldn’t need to do the bottom teeth at all. Standard procedure is just to use teeth whitening on the bottom arch so there is not a big color difference between the two groups. What your dentist is suggesting is a massive overtreatment. Most smiles are eight to ten teeth wide and that should be the most you would need.
About this three year guarantee thing. The bare minimum dental crowns should last is 5 years. When done by a skilled dentist, they should last at least 10 – 15 years. The fact that he is only promising less than the bottom of the barrel also does not invoke much confidence from me.
I’m going to suggest you run away as fast as you can and find a dentist with more expertise. By the way, cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist. Do yourself a favor and look for a dentist with post doctoral training, as well as evidence of doing beautiful work on their smile gallery.
This blog is brought to you by Tucson Prosthodontist Dr. Howard Steinberg.
